Scaphoid hemiresection and arthrodesis of the radiocarpal joint

Radiocarpal arthritis is frequently the result of trauma and/or degenerative disease. The leading causes are malunited or nonunited fractures of the radius or scaphoid, radiocarpal or intercarpal dislocations or dissociations, or a form of primary osteoarthritis or inflammatory arthritis. Management focuses on reducing pain, increasing function, and preserving some degree of motion when possible. Total wrist arthrodesis remains the ultimate salvage procedure. Several surgical procedures attempt to preserve some motion including proximal row carpectomy; lunotriquetrocapitohamate (4-corner) or luno-capito-hamate (3-corner) fusion with scaphoid excision; radiolunate or radioscapholunate; and lunocapitate arthrodesis, and total wrist replacement arthroplasty. These have been used with various success rates. The choice of the procedure depends on which articulation(s) are diseased and which are spared. Motion-sparing procedures require healthy articular cartilage at the site of preserved motion. This paper described scaphoid hemiresection and arthrodesis of the radiocarpal joint, the SHARC procedure.